Plavix (clopidogrel) is a blood thinner that is used to reduce the risk of heart disease and stroke. It is a popular drug and is considered to be safe for most patients. However, there is real risk that patient may not be able to metabolize the drug appropriately, and thus receive no benefit from the medication – or, conversely – suffer adverse reactions to Plavix such as statin myopathy, according to researchers at the University of Maryland, as reported in November at the American Heart Association’s Scientific Sessions in New Orleans.
In response to these findings, the University of Maryland Medical Center has launched a program to conduct genetic tests for the liver enzyme CYP2C19 before prescribing Plavix and other medications to patients who have received a heart stent. The enzyme affects the patient’s ability to metabolize the drug. Sixty percent of the patients with reduced CYP2C19 function were given an alternative medication. The result was reduction of the percentage of heart attacks and death by nearly half compared with those who continued taking clopidogrel.
Alternative medications, while not statistically as effective at Plavix, were found to be adequate replacements, according to the UMMC researchers. Thus, the trial and error process was reduced and patient receive the appropriate medication early in treatment.
“This is a true personalized medicine initiative,” says Mark R. Vesely, MD, an associate professor of medicine at UM SOM and an interventional cardiologist at UMMC who was a co-investigator of the study. “The test provides the ability to optimize therapy for a specific patient by helping us tailor our treatment based on the patient’s unique genetic profile.”
Source: University of Maryland Medical Center “University of Maryland Medical Center Offers Genetic Testing as Standard of Care to Help Improve Outcomes for Heart Stent Patients” (January 2017).